Per CCI Guidelines Procedures Code XXXXX has an Unbundle Relationship With Procedure Code XXXXX Billed for the Same Date of Service. Review Documentation to Determine if a Modifier Override is Appropriate

Rejection Message

PER CCI GUIDELINES PROCEDURE CODE XXXXX HAS AN UNBUNDLE RELATIONSHIP WITH PROCEDURE CODE XXXXX BILLED FOR THE SAME DATE OF SERVICE.

REVIEW DOCUMENTATION TO DETERMINE IF A MODIFIER OVERRIDE IS APPROPRIATE

Rejection Details

This rejection indicates that the claim has not passed “Smart Edits” put in place by the payer.

Smart Edits are based off of Correct Coding Initiative (CCI) rules and are designed to identify claims considered “Certain to Deny” due to billing issues.

Resolution

Please review the claim to verify it is being billed appropriately. If your biller disagrees with the edit, you can simply rebill and resubmit the claim (without making any changes), and it will pass Smart Edits. However, it may still deny upon adjudication.

Tip: Most subscription levels include access to a free code scrubbing tool on the Encounter. Utilizing this feature for all encounters can help prevent code rejections.

Note: Kareo Support cannot provide coding assistance. Please contact your biller/coder with any CPT or ICD code questions.